Healthcare Provider Details

I. General information

NPI: 1235491424
Provider Name (Legal Business Name): JAPERA BLAKNEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2012
Last Update Date: 06/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

189 JOLIET ST SW APT 201
WASHINGTON DC
20032-1819
US

IV. Provider business mailing address

189 JOLIET ST SW APT 201
WASHINGTON DC
20032-1819
US

V. Phone/Fax

Practice location:
  • Phone: 202-374-7478
  • Fax:
Mailing address:
  • Phone: 202-374-7478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number2101490
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: